What’s the difference to biopsy and LLETZ

Hi I went for my colposcopy appointment today with HPV positive and high grade (moderate) cells. However I wasn’t able to have any treatment due to me going on holiday tomorrow and there’s a risk of infection.

Anyway from what I gathered I was meant to have a check today and a biopsy taken to see if I need LLETZ. But the doctor said he would do all the treatment meaning the LLETZ.

Basically is a biopsy and LLETZ the same? I’m so confused?


Hi @Hello2

A LLETZ is mainly a treatment but it is also a type of biopsy as the sample is sent off to the lab for analysis, but its not the same biopsy they use to determine if you need a LLETZ that would be a punch biopsy, its about the size of a grain of rice where as the LLETZ removes around 10mm

Alot of the time they will skip the punch biopsy all together and treat, depending how it looks to them they will make an educated guess on what the grade is, they call this ‘see and treat’ but this runs the risk of over treating as it can look worse/less than what it actually is, smears dont always match up to the biopsy results and the biopsy doesnt always add up to what theyre seeing xx

Hi thank you so much for your reply that’s really helped me.

I think I was just confused because I didn’t expect to be having the LLETZ today (even though I wasn’t able to get it due to holiday) I just assumed I would have this punch biopsy and then see what the results are wether I need the LLETZ.

Maybe because my smear came back moderate they are skipping the punch biopsy like you say and just doing the treatment.

It’s hard being a woman you just have so many worries! Xx